Transcranial Magnetic Stimulation (TMS) Therapy: An Innovative Pillar in Holistic Mental Wellness

TherapyRecovery
Written By Susie Wiet, MD
Young woman breaking through a sheet of pink paper - analogous to Transcranial magnetic stimulation

When traditional treatments don't provide relief for mental health conditions, Transcranial Magnetic Stimulation (TMS) offers new hope. This innovative, non-invasive therapy uses focused magnetic fields to target specific brain regions that influence mood and behavior. For many patients who've tried medications without success, TMS represents a welcome alternative backed by solid research and FDA approval.

The science behind TMS is straightforward yet fascinating. During treatment, a medical professional places a magnetic coil against your scalp. This coil generates brief magnetic pulses that pass painlessly through the skull and create small electrical currents in targeted brain areas. Depending on the settings used:

  • Slower pulses can calm overactive brain regions

  • Faster pulses can stimulate underactive areas

This precision targeting is what makes TMS so effective—it addresses the exact neural circuits involved in your specific condition.

What TMS Can Help With

TMS has earned FDA approval for several conditions, including:

  • Depression that hasn't responded to medication

  • OCD (obsessive-compulsive disorder)

  • Smoking cessation

  • Depression with anxiety symptoms

Many patients with treatment-resistant depression see meaningful improvements after TMS. A typical course involves sessions lasting about 20-40 minutes each day for 4-6 weeks, with many people noticing positive changes within the first few weeks.

Researchers are also exploring TMS for other conditions like PTSD, substance use disorders, and anxiety, with promising early results.

What to Expect as a Patient

If you're considering TMS, here's what the process typically looks like:

  1. Your initial consultation: A provider will review your medical history and previous treatments to determine if TMS is right for you.

  2. Finding the right spot: During your first session, the clinician will identify the exact location for coil placement and determine the appropriate stimulation level for your needs.

  3. Regular treatment sessions: Each session takes about 20-40 minutes. You'll remain awake throughout and can return to your normal activities immediately afterward.

Most people describe the sensation as a tapping feeling on the scalp. While some experience mild discomfort, most find it quite tolerable. Unlike medications, TMS doesn't cause whole-body side effects like weight gain or sexual dysfunction.

How TMS Changes Your Brain

TMS works by encouraging your brain's natural ability to adapt and form new connections. Regular sessions can:

  • Strengthen neural pathways

  • Promote the release of proteins that support brain cell health

  • Help different brain regions communicate more effectively

These positive changes often continue after treatment ends, which explains why many patients experience lasting benefits.

How TMS Compares to Other Treatments

TMS offers several advantages over other brain stimulation therapies:

  • No anesthesia required

  • No seizures induced (unlike ECT)

  • You can drive yourself to and from appointments

  • No memory problems or cognitive side effects

  • No need to adjust your medications

While ECT may work faster for severe depression, TMS provides a gentler option with fewer side effects for many patients.

Advances in TMS Technology

The field continues to evolve with exciting innovations:

  • Deep TMS can reach structures further inside the brain

  • Theta Burst Stimulation has shortened some treatments from 37 minutes to just 3 minutes

  • Navigated TMS uses brain imaging for more precise targeting

These advances are making TMS more effective, convenient, and accessible.

Safety Considerations

TMS has proven remarkably safe for most patients. Common side effects include:

  • Mild headaches that typically resolve within a few hours

  • Temporary discomfort at the treatment site

  • Occasional lightheadedness

Serious side effects are rare. The risk of seizures is less than 0.1% and mainly affects people with pre-existing risk factors. TMS isn't recommended for people with certain metal implants near the head, such as aneurysm clips or deep brain stimulators.

Susie Wiet, MD

Dr. Wiet is an integrative, developmental psychiatrist with expertise in treatment of trauma-addiction, dual diagnosis, and complex psychiatric disorders. She synthesizes functional medicine principles (working with your own biology), honed therapeutic skills (trauma-informed, psychodynamic and EMDR trained), and allopathic (traditional western) medical training to optimize treatment outcomes and conservative use of medication.  

She is the founder, owner, and executive medical director of Sovegna Center for Addiction Treatment and Recovery and the Trauma-Resiliency Collaborative of Utah. She is the author of the Health Resiliency Stress Questionnaire (HRSQ). She has received many awards for teaching, service, initiative, advocacy and excellence of care.  

Dr. Wiet graduated from Northwestern University Medical School in Chicago, IL, and trained at the University of Utah in General Psychiatry and Child/Adolescent Psychiatry (fellowship). She holds three American Medical Board certifications: General Psychiatry, Child and Adolescent Psychiatry, and Addiction Medicine. She is a Volunteer Faculty at the University of Utah Department of Psychiatry and previously full-time faculty as an Assistant Professor.

During her personal time, she enjoys learning from her children, celebrating time with family and friends, hiking, biking, cooking, writing poetry, cultivating creativity, and deepening her faith in prayer.

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